眼上赤脉下贯瞳人囟门肿起兼及作坑鼻干黑燥肚大青筋目多直视睹不转睛指甲黑色忽作
鸦声虚舌退场门啮齿咬人鱼口气急啼不作声蛔虫既出必是死形用药速救十无一生
小儿病困汗出如珠着身不流者死
小儿病其头发皆上逆者必死
小儿病而囟陷其口唇干目皮反口中气出冷手足四垂其卧如缚掌中冷皆不治
小儿中风热喘鸣肩息脉缓则生急则死
小儿痢疾脉浮大而腹痛者必死
乳子病热脉悬小手足温则生寒则死
千金论曰芽儿出腹骨肉未敛肌肉未成犹尚是血血凝则坚而成肌肉也又云如水上之泡草头
之露
夫初生一腊之内天地八风之邪岂能速害良由在胎之时母失爱护或劳动气血相干或坐卧饥饱相
役饮酒食肉冷热相制恐怖惊扑血脉相乱蕴毒于内损伤胎气而降生之后故有胎热胎寒胎肥胎怯
胎惊胎黄诸证生焉外因浴洗拭口断脐灸囟之不得法或绷HT 惊恐乳哺寒温之乖其宜致令噤口脐
风锁肚不乳等证病患致此亦难救疗坐视其毙良可哀悯故黄帝云吾不能察其幼小谓别是一家调
理耳惟小儿脏腑娇嫩血气懦弱肌体不密精神未备而黄帝尤难之也而用药者必明消息形候审定
生死察病患之浅深知药性之寒温乃一世之良工也
胎热者由儿在胎中母多惊悸或因食热毒之物降生之后儿多虚痰气急喘满眼闭目赤目胞浮
肿神
困呵欠呢呢作声遍体壮热小便赤色大便不通时复惊烦此因胎中受热或误服温剂致令热蓄于内
熏蒸胎气故有此证若经久不治则鹅口重舌木舌赤紫丹瘤自此而生宜先以木通散煎与母服使入
于乳令儿饮之通心气解烦热然后以四圣散温洗两目目开进地黄膏凡有胎疾不可求速效当先令
乳母服药使药过乳渐次解之百无一失若节以凉药攻之必生他病乳母仍忌辛辣酒面庶易得安不
致反复
胎寒者婴儿初生百日内觉口冷腹痛身起寒粟时发战栗曲足握拳昼夜啼哭不已或口噤不开
胎寒其证在胎时母因腹痛而致产经云胎寒多腹痛亦有产妇喜啖甘肥生冷时果或胎前外感风寒
暑湿治以凉药内伤胎气则生后昏昏多睡间或 乳泻白若不早治必成慢惊慢脾宜以当归散定其
痛匀气散调其气白术散养其胃气白芍药汤去其寒湿乳母更宜忌口
胎肥者生下肌肉浓遍身血色红盈月以后渐渐羸瘦目白五心烦热大便难时时生涎者是也浴
胎怯者生下面无精光肌肉薄大便白水身无血色目无精采宜以浴体法主之
胎黄者生下遍体面目皆黄状如金色身上壮热大便不通小便如栀汁乳食不思啼哭不止此胎
候也皆因乳母受热而传于胎也凡有此证母子皆宜服地黄汤及地黄饮子有生下百日及半周不因
病后身微黄者胃热也若自生而身黄者胎疸也经云诸疸皆热色深黄者是也犀角散主之若淡黄兼
白者胃怯也白术散主之
胎惊者以胎妇调适乖常饮酒嗜欲忿怒惊扑母有所触胎必感之或外挟风邪有伤于胎故子乘母气
生下即病也其候月内温壮翻眼握拳噤口切牙身腰强直涎潮呕吐搐掣惊啼腮缩囟开或颊赤或面
青眼合凡胎风眼合不可误作慢脾妄用温药其有搭眼噤口之类亦此一种之所发也视其眉间气色
赤而鲜碧者可治若黯青黑者不治虎口指纹曲入里者可治反出外者不治先宜解散风邪利惊化痰
调气贴囟甚则以朱银丸利之凡初生婴儿难以用药如遇此候急取猪乳细研牛黄麝香各少许调抹
入口中即愈矣
锁肚者由胎中受热热毒壅盛结于肛门闭而不通无复滋润所以如此至若第三日不通急令妇人
以温水漱口吸咂儿前后心并脐下手足心共七处凡四五次仍以轻粉半钱蜜少许温水化开时时将
少许服之以通为度如更不通即是肛门内合当以物透而通之金簪为上玉簪次之须刺入二
寸许以苏合香丸纳入孔中粪出为快也若肚腹膨胀不能乳食作呻吟声至于一七难可望其生也
不乳者谓初出胞胎而不吮乳也婴儿初出胎时其声未发急以手拭其口令恶血净尽不得下咽即无
他病若拭口不全恶秽入腹则令腹满气短不能吮乳或产母取冷过度胎中受寒致令儿腹痛也宜用
茯苓丸及木香槟榔散治之
脐风者谓断脐之后被水湿风冷所乘风湿之气入于脐而流入心脾遂令肚腹胀满脐肿身体重着四
肢柔直日夜多啼不能吮乳甚则发为风搐若脐边青黑嘬口不开是为内搐不治爪甲黑者即死其或
热在胸膛伸缩弩气亦令脐肿宜千金龙胆汤主之为妙
嘬口者面目黄赤气息喘急啼声不出盖由胎气挟热兼风邪入脐流毒心脾之经故令舌强唇青聚口
嘬面饮乳有妨若口出白沫而四肢冷者不可救药其或肚胀青筋吊肠卵疝内气引痛皆肠胃郁结不
通致之治法贵乎疏利嘬口最为急候一腊之内见之尤甚以辰砂膏利之即愈
噤风者眼噤口闭啼声渐小舌上聚肉如粟米状吮乳不得口吐白沫大小便皆通自盈月一百二十日
见此名曰犯风噤根据法将护防于未然但有此证急看儿上 有点子先以指甲轻轻刮破次服定命散
辰砂全蝎散之类如口噤不开服诸药不效者生南星去皮脐研为极细末龙脑少许合和用指蘸生姜
汁于大牙根上擦之立开凡脐风嘬口噤风三者虽异其受病之源则一也大抵里气郁结壅闭不通并
宜服淡豆豉汁与吃取下胎毒千金云小儿初生其气高盛若有微患即须下之若不时下则成大疾难
为疗矣紫霜丸量而与之
Background Information:
Book: Youke Leicui (Essentials of Pediatrics); Author: Wang Luan; Dynasty: Ming; Chapter: Fifteen Signs of Death in Infants / ... / Treatment Methods for Various Conditions at Birth (Total 4 Sections); Category: Comprehensive.
Original Text Translation:
If red vessels on the upper eyelids extend downward through the pupil, the fontanelle swells and forms a pit, the nose is dry, black, and parched, the abdomen is distended with visible blue veins, the eyes are mostly fixed staring without moving, the fingernails are black, suddenly making a crow-like sound, the tongue appears flaccid and retracts, the anus clenches, teeth gnash, biting occurs, fishy breath, rapid breathing, crying without sound, and ascaris worms have been expelled; these are necessarily signs of death. If medication is administered urgently to save them, not one in ten will survive.
When an infant is critically ill and sweating profusely like pearls that adhere to the body but do not flow, it indicates death.
When an infant is ill and all hair stands erect, it indicates certain death.
When an infant is ill, the fontanelle is sunken, lips are dry, eye skins are reversed, cold air exits from the mouth, limbs hang down, the lying position is like being bound, and palms are cold; all are untreatable.
When an infant suffers from wind-heat causing wheezing and panting with shoulder lifting, a slow pulse indicates survival, while a rapid pulse indicates death.
When an infant has dysentery with a floating and large pulse accompanied by abdominal pain, it indicates certain death.
When a nursing infant has fever with a suspended and small pulse, warm hands and feet indicate survival, while cold hands and feet indicate death.
The Qianjin Lun (Thousand Gold Formulas) states: When a child emerges from the womb, flesh and bone are not yet consolidated, muscles are not formed, and it is still essentially blood. When blood coagulates, it hardens to form muscle. It also says: [Infants are fragile] like bubbles on water or dew on grass tips.
In the first lunar month after birth, how can the evil pathogens of the eight winds of heaven and earth cause rapid harm? This is primarily because during pregnancy, the mother failed to protect herself properly, or excessive labor disturbed the qi and blood, or sitting/lying, hunger/fullness acted upon each other, drinking alcohol and eating meat created conflicts between cold and heat, and fear, shock, and jolts caused chaotic blood vessels. Toxins accumulated internally, damaging fetal qi. After birth, conditions such as fetal heat, fetal cold, fetal obesity, fetal weakness, fetal fright, and fetal jaundice arise. Externally, improper methods for bathing, wiping the mouth, cutting the umbilical cord, or moxibustion on the fontanelle, or tight binding causing fright, inappropriate breastfeeding, or imbalance of cold and warmth, lead to conditions such as locked jaw, umbilical wind, locked belly, and failure to suckle. Patients suffering from these are difficult to treat. Sitting idly watching them die is truly pitiable. Thus, the Yellow Emperor said: "I cannot examine the young and tender, considering them a separate category requiring different management." Only infants have delicate zang-fu organs, weak qi and blood, loose skin and muscles, and unprepared spirit. The Yellow Emperor found this particularly difficult. Therefore, those who prescribe medicine must clearly understand the waxing and waning of physical signs, determine life and death, observe the depth and superficiality of the patient's condition, and know the cold and warm nature of medicines; only then can they be excellent physicians of their generation.
Fetal Heat arises when the fetus is in the womb and the mother experiences frequent palpitations or fears, or consumes hot and toxic foods. After birth, the infant often has deficient phlegm, rapid breathing, panting, closed eyes, red eyes with swollen eyelids, mental fatigue, yawning, murmuring sounds, high fever throughout the body, dark urine, constipation, and occasional fright and irritability. This is due to heat accumulation in the womb or mistaken use of warming agents, causing heat to accumulate internally and steam the fetal qi, resulting in this condition. If left untreated for a long time, conditions such as thrush, double tongue, wooden tongue, erysipelas, and purple tumors may arise. One should first decoct Mutong San (Akebia Decoction) for the mother to drink, allowing the medicine to enter the breast milk for the infant to consume. This unblocks heart qi and resolves烦热 (irritating heat). Then, wash both eyes with Sisheng San (Four Saints Powder) using warm water. Once the eyes open, administer Dihuang Gao (Rehmannia Ointment). For any fetal disease, do not seek quick effects. First, let the lactating mother take medicine so that the remedy passes through the milk to gradually resolve the issue; this ensures almost no failure. If one abruptly attacks with cooling medicines, other diseases will surely arise. The lactating mother should still avoid spicy, pungent, alcoholic, and wheat products to easily achieve peace and prevent recurrence.
Fetal Cold: Within the first hundred days after birth, the infant feels cold in the mouth, has abdominal pain, shivering chills, occasional tremors, curled legs, clenched fists, incessant crying day and night, or locked jaw. Fetal cold originates during pregnancy when the mother suffered abdominal pain. The Jingyi (Classic of Obstetrics) states: Fetal cold often involves abdominal pain. Also, if the parturient woman enjoys sweet, rich, raw, and cold seasonal fruits, or contracts wind-cold, summerheat, or dampness before delivery and is treated with cooling medicines, injuring fetal qi internally, the infant will be lethargic and sleepy after birth, occasionally having white diarrhea after breastfeeding. If not treated early, it will inevitably become slow convulsion or slow spleen syndrome. Use Danggui San (Angelica Decoction) to alleviate pain, Yunqi San (Regulating Qi Decoction) to regulate qi, Baizhu San (Atractylodes Macrocephala Decoction) to nourish stomach qi, and Baishaoyao Tang (White Peony Root Decoction) to dispel cold-dampness. The lactating mother should further observe dietary restrictions.
Fetal Obesity: Born with thick muscles and reddish blood color throughout the body. After one month, gradually becomes emaciated, whites of the eyes are prominent, five-center heat (palms, soles, chest), difficulty with bowel movements, and frequent salivation. This is Fetal Obesity.
Fetal Weakness: Born with dull complexion, thin muscles, watery stools, lack of blood color in the body, and lack of luster in the eyes. Treat primarily with the Yuti Method (Body Bathing Method).
Fetal Jaundice: Upon birth, the entire body, face, and eyes are yellow, resembling gold color, with high fever, constipation, urine like gardenia juice, poor appetite, and incessant crying. This is a fetal condition, all caused by the mother absorbing heat which transmits to the fetus. For any such condition, both mother and infant should take Dihuang Tang (Rehmannia Decoction) and Dihuang Yinzi (Rehmannia Drink). If an infant is slightly yellow after one hundred days or half a year without illness, it is stomach heat. If yellow from birth, it is fetal jaundice. The classics state: All jaundices are heat-related; deep yellow color indicates this. Xijiao San (Rhinoceros Horn Decoction) is the primary treatment. If pale yellow mixed with white, it is stomach deficiency; Baizhu San (Atractylodes Macrocephala Decoction) is the primary treatment.
Fetal Fright: Due to the pregnant woman’s irregular lifestyle, drinking alcohol, indulging desires, anger, shock, or jolts, whatever touches the mother affects the fetus. Or externally, wind pathogens injure the fetus. Thus, the child inherits the mother’s qi and falls ill immediately after birth. Symptoms within the first month include low-grade fever, rolling eyes, clenched fists, locked jaw, grinding teeth, stiff body and waist, flooding saliva, vomiting, convulsions, frightened crying, shrinking cheeks, open fontanelle, red cheeks, or blue face, and closed eyes. Whenever fetal wind presents with closed eyes, do not mistakenly treat it as slow spleen syndrome and recklessly use warming medicines. Conditions such as drooping eyes and locked jaw are also manifestations of this type. Observe the qi color between the eyebrows: if red and bright green, it is treatable; if dark, blue-black, it is untreatable. If the tiger-mouth fingerprint curves inward, it is treatable; if it extends outward, it is untreatable. First, disperse wind pathogens, benefit from calming fright, resolve phlegm, regulate qi, and apply patches to the fontanelle. In severe cases, use Zhuyin Wan (Cinnabar Silver Pill) to purge. Since it is difficult to medicate newborns, if this condition occurs, urgently take pig milk, finely grind Niuhuang (Calculus Bovis), and Shexiang (Musk), mix in small amounts, and smear into the mouth for immediate recovery.
Locked Belly: Caused by heat accumulating in the womb, with abundant heat-toxin blocking the anus, closing it off without lubrication. If stool does not pass by the third day, urgently instruct a woman to rinse her mouth with warm water, then suck on seven points of the infant: front and back of the chest, below the navel, and centers of hands and feet, four or five times. Still, dissolve Banqian (Calomel, 0.5 qian) and a little honey in warm water, and administer small amounts frequently until passage occurs. If still blocked, the anus is internally closed; use an object to penetrate and open it. A gold hairpin is best, a jade hairpin is second best. Insert about two cun, then insert Suhexiang Wan (Styrax Pill) into the hole. Relief comes when feces are expelled. If the abdomen is distended, unable to suckle or eat, groaning, and reaching the seventh day (one week), hope for survival is slim.
Failure to Suckle: Refers to the newborn not sucking milk upon exiting the amniotic sac. When the infant first emerges, if the cry has not started, urgently wipe the mouth with hand to ensure all foul blood is cleared and not swallowed; then there will be no other illness. If wiping is incomplete and foul matter enters the abdomen, it causes abdominal fullness, shortness of breath, and inability to suckle. Or if the mother exposed herself to excessive cold, causing the fetus to absorb cold, leading to infant abdominal pain. Use Fuling Wan (Poria Pill) and Muxiang Binglang San (Costus and Betel Nut Powder) for treatment.
Umbilical Wind: Refers to after cutting the umbilical cord, being invaded by water-dampness and wind-cold. Damp-wind qi enters the umbilicus and flows into the heart and spleen, causing abdominal distension, umbilical swelling, heavy body, rigid limbs, frequent crying day and night, inability to suckle, and eventually wind convulsions. If the umbilical area is blue-black, mouth pursed and unable to open, it is internal convulsion, untreatable. If fingernails are black, death ensues. If heat is in the chest, extending and retracting with strained breathing, it also causes umbilical swelling. Qianjin Longdan Tang (Qianjin Gentian Root Decoction) is excellent for treatment.
Pursed Mouth: Yellow-red face and eyes, rapid breathing, absent crying. This is due to fetal qi carrying heat combined with wind pathogens entering the umbilicus, flowing toxins into the heart and spleen meridians, causing stiff tongue, blue lips, pursed mouth, and difficulty feeding. If white foam issues from the mouth and limbs are cold, it is incurable. Abdominal distension, visible blue veins, hanging intestines, hernia, and internal qi pulling pain are all caused by gastrointestinal stagnation and blockage. Treatment values dispersing and purging. Pursed mouth is the most urgent condition. Seeing it within the first lunar month is especially severe. Use Chensha Gao (Cinnabar Paste) to purge for immediate recovery.
Locked Wind: Eyes locked, mouth closed, voice gradually diminishing, flesh on the tongue gathered like millet grains, unable to suckle, spitting white foam, normal urination and defecation. Appearing after full month up to 120 days is called Fanfeng Jin (Violating Wind Lock). Follow methods to care for and prevent this beforehand. But if this condition exists, urgently check if the infant has spots. First, gently scratch them with fingernails, then administer Dingming San (Life-Determining Powder) or Chensha Quanxie San (Cinnabar and Scorpion Powder). If the mouth remains locked and various medicines fail, use Sheng Nanxing (Raw Arisaema) peeled and de-umbilicated, ground to extremely fine powder, mixed with a little Longnao (Borneol). Dip finger in fresh ginger juice and rub on the molar roots to open the mouth immediately. Although Umbilical Wind, Pursed Mouth, and Locked Wind differ, their source of disease is one. Generally, interior qi stagnation and blockage should all take Dan Dou Chi Zhi (Fermented Soybean Juice) to drink and expel fetal toxins. Qianjin states: Newborns have strong qi and abundant essence; if even slight ailments occur, purgatives must be used. If not purged promptly, major diseases develop, difficult to treat. Zishuang Wan (Purple Frost Pill) should be given according to dosage.